The meaning of being conscious during surgery with local or regional anesthesia-A phenomenological hermeneutic study

Background: With increasing prevalence of surgery under local or regional anesthesia, which allows patients to remain conscious during the intraoperative phase, there is a growing need to comprehend the lived experiences associated with this practice. Objective: This study aimed to illuminate the lived experiences of individuals who remained conscious during surgical intervention under local or regional anesthesia. Design: A qualitative design was chosen. Setting(s): Participants in the present study were recruited from three surgical wards located in central Sweden using a purposive sampling strategy. The surgical disciplines included ear, gynecological, hernioplasty, orthopedic, and vessel surgeries. Participants: Fourteen narrative interviews were conducted with individuals who had undergone elective surgery while conscious. Methods: Verbatim transcribed text was analyzed using a phenomenological-hermeneutic method. Results: The lived experience of being conscious during surgery was marked by feelings of hope alongside a sense of losing one's identity and experiencing destabilization. Structural analysis revealed two themes. The first theme, 'being in the hands of others', encompassed subthemes such as 'entering an unfamiliar environment and procedure,' 'losing foothold and a sense of selfidentity,' and 'enduring unexpected or anticipated discomfort.' The second theme, 'managing the inevitable for future health concerns,' involved subthemes such as 'pursuing self-acceptance of the situation,' 'entrusting the professionals while seeking signs of a smooth procedure,' and 'Enhancing own resilience through continuous support. Conclusions: Beyond the patient's physical well-being during surgery, the OR team should acknowledge the "person" component and focus on their emotional and social needs in this vulnerable situation. The four meta-paradigms of nursing-person, health, environment, and nursing-significantly influence the conscious patient's experience. Patient or Public Contribution: No patient or public contribution